Comparison of surgically induced astigmatism between one-handed and two-handed cataract surgery techniques

Abstract

Atsushi Kawahara,1 Daijiro Kurosaka,2 Akitoshi Yoshida31Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, 2Department of Ophthalmology, Iwate Medical University, Morioka, 3Department of Ophthalmology, Asahikawa Medical University, Asahikawa, JapanBackground: The purpose of this study was to compare surgically induced astigmatism (SIA) between one-handed and two-handed cataract surgery techniques.Methods: Eighty-eight eyes of 44 patients with no ocular disease other than cataract, who underwent cataract surgery by a single surgeon, were selected for this study. Cataract surgery was performed by coaxial phacoemulsification and intraocular lens implantation via a 2.4 mm transconjunctival single-plane sclerocorneal incision at the 12 o'clock position. In each patient, one eye was subjected to coaxial phacoemulsification using a one-handed technique while the fellow eye was subjected to coaxial phacoemulsification using a two-handed technique. For the two-handed technique, a corneal side port was created at the 2 o'clock position. The appropriate incision meridian was identified by a preoperative axis mark. SIA was calculated using the Alpins method.Results: Mean SIA was 0.40 ± 0.28 diopters (D) in the one-handed technique group and 0.39 ± 0.25 D in the two-handed technique group. No statistically significant difference was found in the mean SIA score. The mean torque value was −0.05 ± 0.26 D in the one-handed technique group and 0.11 ± 0.37 D in the two-handed technique group. Mean torque was significantly lower (P<0.05) in the one-handed technique group than in the two-handed technique group.Conclusion: The results indicate that the corneal side port in two-handed cataract surgery has a rotating effect on the axis of astigmatism.Keywords: cataract surgery, corneal side port, surgically induced astigmatism